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Pricey Dental Implants Not Always Necessary, Study Finds

Teeth that are salvageable may be better off treated than replaced, experts say

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, Oct. 3 (HealthDay News) -- Dental implants are reliable replacements for teeth that are already missing, but they're not always the best choice for diseased teeth, a new study indicates.

Instead, attempts to save the tooth with treatment, especially in cases of gum or periodontal disease, should sometimes be tried first, the lead researcher said. And although the study did not address expense, dental implants are not cheap, costing roughly $3,500 for the complete treatment.

"Preserving teeth by proper periodontal treatment and a careful and frequent maintenance program will probably give the same, and even better, results for the long run," said study co-author Dr. Liran Levin, an assistant professor of periodontology at the Israel Institute of Technology and a visiting assistant professor at the Harvard School of Dental Medicine in Boston.

He reviewed 19 published studies that looked at either implant survival rates or tooth survival rates over at least 15 years. The results are published in the October issue of the Journal of the American Dental Association.

Levin found that about 4 percent to 13 percent of teeth not implanted were lost. None to 33 percent of implants were lost. According to the U.S. National Institutes of Health, an implant is viewed as successful if it is functional for five years in 75 percent of cases.

"This is one of the first reviews comparing the long-term survival of dental implants as opposed to properly treated and maintained teeth," Levin said.

Dental implants are one of the biggest advances in dentistry in the past 40 years, according to the American Dental Association website. The procedure usually requires three phases once the natural tooth is extracted or missing. First, the dentist surgically places the implant -- a post-like device that serves as an anchor -- into the jawbone. The bone around the implant is allowed to heal. An artificial tooth is made to fit over the implants.

Based on the results of the review, Levin said he tells patients: "When advised to extract a tooth, don't rush into that. Try to seek a second opinion, be sure to treat the disease [if any] and eliminate it before going through dental implantation. Always ask about the possibility not to extract."

In some cases, of course, implants are preferred, Levin said. "There are several cases that usually require tooth extraction and are unsalvageable." For instance, he said, teeth with vertical root fractures or other structural problems.

However, some dentists are over-recommending implants, he said. "This might result from their belief that dental implants are better, which was proved wrong in our review, or from other reasons," he said.

Dr. Edmond Hewlett, a spokesperson for the American Dental Association and a professor of restorative dentistry at the University of California, Los Angeles School of Dentistry, said he doesn't get the sense that dentists are over-recommending implants.

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Only 18.5% of Americans never floss. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Floss removes food trapped between the teeth and removes the film of bacteria that forms there before it turns to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Try flossing just one tooth to get started.

You are one of 31% of Americans who don't floss daily. You are missing out on a simple way to make a big difference in the health of your mouth. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for 3 more days!

You are one of 31% of Americans who don't floss daily, but you're well on your way to making a positive impact on your teeth and gums. Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Aim for all 7 days!

Only 50.5% of Americans floss daily, and good for you that you are one of them! Regardless of how well you brush, plaque still forms between your teeth and along your gums. Toothbrush bristles alone cannot clean effectively between these tight spaces. Flossing removes up to 80% of the film that hardens to plaque, which can cause inflamed gums (gingivitis), cavities, and tooth loss. Congratulations on your good oral health habit!

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American Dental Association, Healthy People 2010

This tool is intended only for adults 18 and older.

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